Healthcare Provider Details

I. General information

NPI: 1215102017
Provider Name (Legal Business Name): FLORIDA MANAGED CARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 BLUE LAGOON DR SUITE 270
MIAMI FL
33126-2064
US

IV. Provider business mailing address

5201 BLUE LAGOON DR SUITE 270
MIAMI FL
33126-2064
US

V. Phone/Fax

Practice location:
  • Phone: 305-323-1698
  • Fax:
Mailing address:
  • Phone: 305-323-1698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN HENRY HARKINS
Title or Position: PRESIDENT
Credential:
Phone: 305-323-1698